Liu Taisheng, Wu Hua, Zhuang Xianmian, Lu Di, Cai Ruijun, Wang Wujun
Department of Thoracic and Cardiovascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Zhongguo Fei Ai Za Zhi. 2014 Apr;17(4):327-35. doi: 10.3779/j.issn.1009-3419.2014.04.07.
Platinum plus a third-generation agent doublet chemotherapy is the standard regimen and first-line chemotherapy for the treatment of advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy and safety of docetaxel plus platinum (DP) compared with vinorelbine plus platinum (VP) regimens in patients with advanced NSCLC.
We searched the PubMed, EMBASE, Cochrane Library, CNKI, CBM, VIP, and WanFang databases for randomized controlled trials (RCTs), in which DP regimen was compared with VP regimen. A quality assessment of qualified RCTs was performed according to Cochrane Handbook 5.1.0, and Stata 12.0 was used to perform meta-analysis.
Seven RCTs involving 2,318 patients were included. Meta-analysis results indicated that the DP regimen increased the two-year survival rate (HR=0.887, 95%CI: 0.810-0.972, P=0.010), response rate (RR=1.276, 95%CI: 1.107 -1.450, P=0.001), and diarrhea rate (RR=3.134, 95%CI: 1.918-5.121, P<0.001) compared with the VP regimen. Anemia rate was also reduced (RR=0.386, 95%CI: 0.311-0.478, P<0.001). No statistical differences were observed between DP and VP regimens in terms of one-year survival rate, leukopenia, neutropenia, thrombocytopenia, anorexia, nausea, and vomiting.
DP regimen reduced the rate of anemia and increased the rate of diarrhea, two-year survival rate, and response rate. Therefore, DP regimen may be a more effective option as a first-line treatment for advanced NSCLC compared with VP regimen.
铂类联合第三代药物的双联化疗是晚期非小细胞肺癌（NSCLC）的标准治疗方案和一线化疗方案。本研究旨在评估多西他赛联合铂类（DP）方案与长春瑞滨联合铂类（VP）方案治疗晚期NSCLC患者的疗效和安全性。
我们检索了PubMed、EMBASE、Cochrane图书馆、中国知网、中国生物医学文献数据库、维普资讯和万方数据库，查找比较DP方案与VP方案的随机对照试验（RCT）。根据Cochrane手册5.1.0对纳入的合格RCT进行质量评估，并使用Stata 12.0进行荟萃分析。
纳入了7项涉及2318例患者的RCT。荟萃分析结果表明，与VP方案相比，DP方案提高了两年生存率（HR = 0.887，95%CI：0.810 - 0.972，P = 0.010）、缓解率（RR = 1.276，95%CI：1.107 - 1.450，P = 0.001）和腹泻率（RR = 3.134，95%CI：1.918 - 5.121，P < 0.001）。贫血率也有所降低（RR = 0.386，95%CI：0.311 - 0.478，P < 0.001）。在一年生存率、白细胞减少、中性粒细胞减少、血小板减少、厌食、恶心和呕吐方面，DP方案与VP方案之间未观察到统计学差异。
DP方案降低了贫血率，提高了腹泻率、两年生存率和缓解率。因此，与VP方案相比，DP方案作为晚期NSCLC的一线治疗可能是更有效的选择。
